Speaking at the annual conference of The National Academy of Sciences Monday, President Obama said that declaring the swine flu outbreak a national health emergency was a prudent measure and no reason for panic. He's getting regular updates and briefings from John Brennan, assistant to the president for homeland security and counterterrorism; Dr. Richard Besser, acting director of the Centers for Disease Control and Prevention; and Janet Napolitano, secretary of homeland security.

The Centers for Disease Control and Prevention (CDC) has already taken important steps. The CDC has stated: "Laboratory testing has found the swine influenza A (H1N1) virus susceptible to the prescription antiviral drugs such as [Tamiflu (oseltamivir phosphate), Relenza (zanamivir)] and has issued interim guidance for the use of these drugs to treat and prevent infection with swine influenza viruses. CDC also has prepared interim guidance on how to care for people who are sick and interim guidance on the use of face masks in a community setting where spread of this swine flu virus has been detected. This is a rapidly evolving situation and CDC will provide new information as it becomes available."

The United States government already has guidance in place on community mitigation and relies on knowledge of the Pandemic Severity Index (PSI) to characterize the severity of a pandemic and identify the recommendations for specific interventions that communities may use for a given level of severity, and suggests when these measures should be started and how long they should be used. [See: Preparing Businesses for a Pandemic]

Companies and employers that have not done so are being urged to establish a business continuity plan should the government direct state and local governments to immediately enforce their community containment plans.

If the Federal government does direct states and communities to implement their emergency plans, recommendations, based on the severity of the pandemic, may include:

• Asking ill people to voluntarily remain at home and not go to work or out in the community for about 7-10 days or until they are well and can no longer spread the infection to others (ill individuals may be treated with influenza antiviral medications, as appropriate, if these medications are effective and available.
• Asking members of households with a person who is ill to voluntarily remain at home for about 7 days (household members may be provided with antiviral medications, if these medications are effective and sufficient in quantity and feasible mechanisms for their distribution have been developed).
• Dismissing students from schools (including public and private schools as well as colleges and universities) and school-based activities and closure of childcare programs for up to 12 weeks, coupled with protecting children and teenagers through social distancing in the community, to include reductions of out-of-school social contacts and community mixing. Childcare programs discussed in this guidance include centers or facilities that provide care to any number of children in a nonresidential setting, large family childcare homes that provide care for seven or more children in the home of the provider, and small family childcare homes that provide care to six or fewer children in the home of the provider.
• Recommending social distancing of adults in the community, which may include cancellation of large public gatherings; changing workplace environments and schedules to decrease social density and preserve a healthy workplace to the greatest extent possible without disrupting essential services; ensuring work-leave policies to align incentives and facilitate adherence with the measures outlined above.